A practical questionnaire for predicting denture success or failure. The need and value to predict success and failure in treatment of denture patients are great. The psychological and emotional factors involved are just as important as if not more important than the oral and systemic findings. The value of a simple questionnaire for the edentulous and immediate denture patients has been presented. The authors believe that all schools should present advanced information on the psychological aspects of dental care.


Self-image and its relation to denture acceptance. A study was initiated to determine whether a relationship exists in geriatric patients between self-image and the extent of their denture acceptance. Three assessing instruments were employed, namely, a "Focused Interview," the embedded-figures test, and projective figure drawings. Scores obtained were compared with scores on the Denture-Acceptance Rating Scale. The research results derived from the data follow: 1. Comparison of the degree of denture acceptance with the scores on all three assessing instruments showed significant relationships. Therefore, the hypothesis under study was accepted. 2. The "Focused Interview" appeared particularly well suited to a geriatric population, because it was nonthreatening, provided a communication outlet, and can be readily employed by a practitioner. 3. The embedded-figures test and the projective figure drawings appeared less appropriate for this population because of factors such as psychomotor retardation, perceptual difficulties, and diminution of ego strength which accompany the aging process. 4. The men in this study appeared to accept dentures more readily than the women, manifested higher morale, and were more field-independent. 5. Employed subjects, as compared to unemployed, showed significantly greater denture acceptance, higher morale and self-image, and a greater degree of field-independence. These factors appeared related to greater flexibility of adaptation. 6. Socioeconomic factors appeared to be significantly and positively related to morale factors. 7. Complaints regarding dentures were largely of a physical nature. They appeared to relate primarily to difficulties with adjustment to the new artifact which represented an alteration of body image for the subjects. 8. The study provided corroborative evidence of the need for the dentist to make an initial assessment of those personality factors in his patients which might limit his ability to provide adequate dental services.


Comparing ridge resorption with various surgical techniques in immediate dentures. The three surgical techniques of simple tooth extraction and labial plate and intraseptal alveoloplasty were compared. The results were confirmed by statistical analysis. The conclusion of this study clearly indicated that simple tooth extraction is the best surgical approach to be followed to preserve as much of the residual alveolar ridge as possible.


Tissue pressure under complete maxillary dentures. This preliminary report has shown the following interesting points: (1) Measurements of tissue pressures beneath dentures are possible using the Sanborn 350 recorder. (2) Stable dentures produce high pressures on the supporting tissues and transmit these pressures from region to region, varying with how the patient uses the dentures. (3) Most often, an opposite large or negative pressure immediately followed the production of positive pressure at the same site beneath the denture. Thus, each movement actually traumatizes the tissue twice. (4) Nonmasticatory pressures produced under dentures are as great as or greater than masticatory pressures. (5) Wave forms for each biting maneuver or sound produced can be charted and are typical for each patient, probably representing denture movement. (6) Swallowing unassociated with eating or drinking produced very high positive and very low negative pressures, giving the greatest ranges of pressures recorded in this experiment. (7) Smoking (recorded in only one patient) also produced a great range of pressures. (8) Sticky foods such as cheddar cheese produced greater negative pressures than the other foods tested. (9) The one patient with natural teeth opposing his denture gave much more uniform and lower pressures than did the patients with complete dentures. (10) This method allows visualization of pressure movement under dentures. The effect of these continually occurring, nonmasticatory, induced pressure changes and pressure waves beneath the dentures may well be of greater significance than that of mastication.


Tissue reaction to acrylic resin.

Tissue reaction to acrylic resin.


Pulp reaction to a temporary zinc oxide/eugenol cement. The pulpal irritation, such as inflammatory reaction and aspiration of pulpal cells, demonstrated after insertion of the zinc oxide/eugenol cement (Nobetec) seems to warrant the following recommendations: (1) A temporary restoration with a zinc oxide/eugenol base should not be inserted in deep cavities without a protective liner or a calcium hydroxide base covering the exposed dentinal tubules. (2) Before the temporary cementing of inlays and crowns with a zinc oxide/eugenol cement, not only should the dentin be properly cleaned and debris removed, but the prepared surfaces should be covered with a calcium hydroxide liner.


Extracoronal amalgam restorations utilizing available tooth structure for retention. The rationale and technique for an alternative to placement of pins for retention of amalgam restorations have been presented. The non-pin-retained extracoronal amalgam provides a permanent restoration, capable of fine marginal adaptation, natural contour, excellent occlusion, and remarkable durability.


Morphology of gingival capillaries adjacent to complete crowns. Clinically normal gingivae adjacent to natural teeth did not exhibit dilated capillaries. The morphologies of the capillary loops were of the normal and mixed types. More than one fourth of the capillary loops in the gingivae adjacent to the complete crowns showed dilatation. The capillary loops were of the mixed and complex forms. Dilatation and complex capillary loops were found in the clinically normal gingivae adjacent to the complete crowns. The capillary microscope is an aid in the diagnosis of gingivae adjacent to complete crowns.


Mandibular replacements--a review of embedded implants.


Rehabilitating dentulous hemimandibulectomy patients. A hemimandibulectomy can have many debilitating consequences, such as an eccentric occlusion, a disoriented masticatory cycle, facial disfigurement, distorted speech, and salivation problems. If prosthetic treatment begins some time following surgery and the cicatricial tissue has already consolidated, additional treatment time is necessary. A technique is described which combines crowns with a maxillary prosthesis to guide the mandible into a functional occlusion.


Cardiotoxic effects of psychotropic drugs.


Examination forms for edentulous patients--a survey. Examination and diagnosis forms for edentulous patients from 46 dental colleges in the United States were used in this study. Selected data were taken from each form and compiled under four general and 15 specific entries. Some college forms use entries requiring few and succinct responses,while other forms use entries requiring many and detailed responses. It appears that a correlation does exist between the thoroughness of the examination form and the proficiency of the dental student rendering complete denture therapy. Stated in a positive manner, this survey of college complete denture examination forms suggests that most dental students: use a separate complete denture form for the examination and diagnosis; ask for the chief complaint of the patient; ask one to four questions on past dental history; record 10 to 19 entries relating to oral anatomy; record one to four entries relating to oral physiology; record the mental attitude using two to four descriptive terms; and record one prognosis. Stated in a negative manner, this survey of college complete denture examination forms suggest that most dental students: do not examine the present complete dentures worn by the patient; do not use oral diagrams to show unfavorable or abnormal areas; do not ask for a prognosis in two or more areas; do not ask if the patient wears complete dentures at night; do not ascertain the attitude of the patient after receiving complete dentures; do not ask questions on complete denture expectations; do not use an interview form; and do not work with a staff dentist who has a psychology degree. The intent of this study is to create a spectrum of awareness concerning the presence or absence of specific information on the examination forms. Complete denture examination forms would be more beneficial to the dental student if they provided a high quality of pertinent clinical information. This information would aid the dental student in making an intelligent diagnosis, treatment plan, and prognosis.


Some substituted naphthazarins as potential anticancer agents. Some 2,3-bis(substituted methyl)naphthazarins and related compounds were synthesized by the Diels-Alder reaction of benzoquinone and 2,3-dimethylbutadiene followed by oxidation and substitution reactions. These compounds were prepared as potential biological alkylating agents. Screening results indicated that 1,4-diacetyl-6,7-dimethyl-4a,5,8,8a-tetrahydronaphthalene and 5,8-bis(benzoyloxy)-2,3-dimethyl-1,4-naphthoquinone possessed borderline activity against leukemia P388 and that naphthazarin diacetate possessed confirmed cytotoxicity against the cell culture of human epidermoid carcinoma of the nasopharynx.


Roentgen manifestations of benign masses of the breast.


Crossover femoro-femoral grafts.

Crossover femoro-femoral grafts.


Current thoughts on laboratory aids in the diagnosis of syphilis.


Non-invasive techniques in the evaluation of lower limb ischemia.


Amyloid producing malignant melanoma.

Amyloid producing malignant melanoma.


PSRO--what is it?

PSRO--what is it?


Dry socket.......pardon the terminology.


Diagnostic problem of the mouth. Case number 5.


Diagnostic problem of the mouth. Case number 6.


More on the Sargenti controversy.

More on the Sargenti controversy.


A synopsis of formulating and implementing a voluntary hypertension screening program by dentists in the Northeast Dental Society.


Syphilis--a possible hazard to the dental team.


Diagnostic problem of the mouth.

Diagnostic problem of the mouth.


Communication: the vital link to successful dental practice.


The National Health Planning and Resources Development Act.


Health Manpower Act would tighten federal grip on dentists--physicians.


Diagnosis problem of the mouth. Case number 10.


How do you get into dental school? Grades....scores....luck.


Missouri Dental Service, Inc.

Missouri Dental Service, Inc.


Report of the 25th National Dental Health Conference April 14-16, 1975.


A dental office approach to hypertensive screening.


Retiring President's report.

Retiring President's report.


Diagnosis problem of the mouth. Case number 8.


Tics following methylphenidate administration. A report of 20 cases. Among children receiving methylphenidate hydrochloride, tics developed in 14, and in six children with pre-existing tics, the tics became worse. The clinical diagnosis in 19 cases was minimal brain dysfunction (MBD), and in one case, Gilles de la Tourette syndrome. Duration and dose of medication showed no particular pattern. In only one case did tics persist unchanged after methylphenidate treatment was discontinued. Tics related to methylphenidate administration appear to be rare (20 of 1,520 cases, or 1.3%) and may point to a specific susceptibility possibly related to personality profile (obsessive, perseverative, withdrawn).


Physical factors of N2O and O2. Part V. Pharmacokinetics; relevant administrative pharmacological factors.


Philadelphia chromosome with t(6;22) (p25;q12).


Physical factors of N2O and O2. Part 3. Commercial production of O2 and N2O.


Physical factors of N2O and O2. Part VI. Pharmacodynamics.


Physical aspects of automatic respirators. Objective of artificial ventilation is to maintain sufficient gas exchange with the lowest degree of mechanical burden to the lung that is possible. The basic principle of IPPV is a pressure gradient between the upper airways and the alveoli during inspiration, thus creating a positive gas flow to the lungs. Different technical arrangements can be chosen to overcome the resistances of the lung, depending upon whether the flow or the pressure is the underlying parameter for artificial ventilation. The driving system can be either compressed gas from a pipeline or an electrically driven pump or compressor. With the direct acting generator, the force of the driving mechanism directly inflates the lung, whereas the indirect acting generator has flexible coupling element between pump and patient. The switchover from inspiration to expiration is determined by the cycling parameter, uhich can either be the pressure, the flow, the volume or the time. The mode of cycling influences the reaction of the respirator to changing lung conditions. Only the volume and time cycled types maintain a constant ventilation volume with changing lung resistances. Lastly, the different behavior of respirators during expiration is discussed. An active support of expiration by means of a negative pressure has less meaning nowadays. On the other hand, a positive end expiratory pressure (PEEP) has turned out to be a very helpful tool in long-term ventilation.


Inaugural address.

Inaugural address.


Physical factors of N2O and O2. Part 4. Solubility.


Combination chemotherapy in recurrent carcinoma of the breast.


A comparison of cannulas number 1104 and number 66.


Management of pulmonary embolism.

Management of pulmonary embolism.


I-thou or I-it-the doctor and the patient.


Assets and liabilities of helicopter evacuation in support of emergency medical services.


Behavior modification. Present status in psychiatry.


Disability determination under Social Security and the new supplemental security income program. Contrasts and similarities.


Ameloblastic odontoma. Clinicopathologic study.


Physicians help make rhythm work.

Physicians help make rhythm work.


Serum magnesium levels in nonacute schizophrenia.


Calcitonin. Its physiologic roles.

Calcitonin. Its physiologic roles.


Acid-base balance in disorders of calcium metabolism.


Stomach with ram's horn sign.

Stomach with ram's horn sign.


Electrocardiograms of the month.

Electrocardiograms of the month.


The ailing mythical osteocyte.

The ailing mythical osteocyte.


Multiple intraosseous ganglia in same extremity.


Prinzmetal's variant angina with syncope. Treatment with permanent demand pacemaker.


Fatal fecaloma.

Fatal fecaloma.


Anicteric cholecystitis with very high serum glutamic oxaloacetic transaminase.


Thromboembolic disease and cardiorespiratory syndrome of obesity.


Tubo-ovarian actinomycosis.

Tubo-ovarian actinomycosis.


Early congenital syphilis.

Early congenital syphilis.


Posterolateral sclerosis in diabetic patient.


Lymphangioma of pancreas.

Lymphangioma of pancreas.


Small-bowel volvulus with aplastic anemia.


Health services dilemma, Chinatown, New York City.


Genital herpes simplex in the female 1968 to 1973. One hundred and twenty-nine female patients with genital herpes simplex infection are considered. Diagnosis and management are discussed, and the importance of excluding other sexually transmitted diseases is emphasised.


Verapamil and the heart: Pharmacological and Therapeutic Considerations. Verapamil is a new anti-anginal and anti-arrhythmic drug whose pharmacological actions can be related to its specific blocking effect on the transmembrane transport of calcium ions. Intravenous verapamil slows the ventricular rate in atrial fibrillation and flutter with an occasional patient reverting to sinus rhythm. The drug promptly terminates most cases of paroxysmal supraventricular tachycardias. It is likely to become the initial agent of choice in the acute treatment of this arrhythmia. Verapamil is not effective in ventricular tachycardia or in atrial fibrillation complicating the WPW syndrome. Few side effects are encountered following intravenous verapamil expecially when the drug is given slowly. Verapamil is also effective in angina in a dose of 120mg tds orally. Little is known of the metabolism and pharmacokinetic of verapamil but the available experience in arrhythmias clearly justifies further study.


Coronary risk factors in New Zealand Maori and European adolescents: The Rotoua Lakes Study 2. A survey if 298 adolescents was carried out by questionnaire, medical examination, anthropometric and biochemical methods, to determine the prevalence of risk factors for coronary heart disease particularly those that might explain the known difference in atherosclerotic mortality between European and Maori women. Data on blood pressure, obesity and serum lipids are presented here, and are discussed together with smoking and serum uric acid. Obesity, hypertriglyceridaemia, smoking and hyperuricaemia all contributed to a higher coronary risk status for Maori subjects.


Editorial: The recognition of brain death.


Acute renal artery occlusion.

Acute renal artery occlusion. Eeven cases of acute renal artery occlusion are reviewed. The clinical presentation and features of the condition are discussed and reasons for delays in diagnosis are examined. Two cases in whom active treatment was carried out are described in detail. Acute renal artery occlusion is most common in patients with severe cardiac disease and this may influence decisions on treatment.


Letter: Sri Lankan doctors in New Zealand.


Letter: Food poisoning.

Letter: Food poisoning.


Letter: Chiropractic and manipulative medicine.


A steroid anaesthetic for cats.

A steroid anaesthetic for cats.


Milk leucocyte counts and their significance in mastitis control.


An intensive calf-rearing unit.

An intensive calf-rearing unit.


The future use of cytogenetics in the manipulation of domestic animal populations.


Man and his food.

Man and his food.


Professionals and advertising.

Professionals and advertising.


Editorial: Readers and writers.

Editorial: Readers and writers.


Letter: An exchange of letters: GHDI dental plan.


Letter: Revision of the code of ethics.

Letter: Revision of the code of ethics.


A report on the council on dental health. The hepatitis B serological survey.


Plight of the elderly.

Plight of the elderly.


The relationship between the generalist and the specialist.


Relevancy requirements for a school dental health program.


Treatment of massive dentigerous cysts of the mandible: a report of two cases.


Periodontic procedures in endodontics.

Periodontic procedures in endodontics.


Dentists and oral cancer: the experience and attitudes of the practitioner.


Improved technique of endodontic stabilization--biofunctional considerations.


A technique for open reduction of subcondylar fractures. Described is a safe and efficient technique for open reduction of the subcondylar fracture. The technique utilizes a Risdon incision to expose the fracture site and a stab incision in the preauricular region. A University of Tennessee drill guide or bone screw is introduced through the stab incision to facilitate placement of drill holes in the fragments, threading of the transosseous wires, and repositioning of the condyle within the fossa.


Chrome cobalt and gold implant for the reconstruction of a traumatized orbital floor. Diplopia and enophthalmos were two sequelae of injuries to the orbital floor. These have been corrected by chrome cobalt and gold implants in the reconstruction of the orbital-floor defect after the inferior rectus and inferior oblique muscles and the orbital structures were freed from the area of blowout. An infraorbital approach was used for access.


Correction of mandibular dentoalveolar retrusion by anterior segmental advancement. Mandibular anterior segmental advancement offers an alternative mode of management for certain patients with Class II dentoalveolar malocclusion. The procedure is ideally indicted in paradoxical occlusal situations wherein Class II malocclusion is associated with a prognathic profile or when total body advancement would produce an unacceptable occlusion or profile. Arch expansion and augmentation genioplasty may be achieved by tailoring the surgical approach. Complications were minimal in the cases presented. Since arch lengthening results, the potential food table is increased, necessitating either fixed or removeable prosthetic care.


Pregnancy and von Gierke's disease.

Pregnancy and von Gierke's disease. A detailed description of the course of pregnancy in a patient with von Gierke's disease is presented. Careful dietary control together with proper management of the hematologic complications of the disease led to a successful outcome.


A rare local anesthetic misadventure. Case report and anatomic considerations. When the mouth is fully opened, the depth to which the needle is inserted need not be great in order to pass through the submandibular gland capsule, and insertion of the needle behind the second molar tooth would result in passage behind the posterior border of the my-ohyoid muscle. The discussion indicates the relative ease with which fluid may penetrate the parapharyngeal space, particularly if pressure is used in injecting. Fluid diffusing into the region of the carotid triangle may have been responsible for the various symptoms, and anesthesia of the hypoglossal nerve, nerve, thyrohyoid nerve, internal and external laryngeal nerves, and carotid body possibly occurred. Anesthesia of the vagus is a remote possibility.


Patient motivation and response to surgical correction of prognathism. Twenty-five patients operated upon between 1969 and 1973 for correction of mandibular prognathism were recalled in 1975 and asked to evaluate their attitudes toward the procedure and the postoperative results. All but one were satisfied with the results. Postoperative numbness of the lip and chin lasting more than 6 months was commonly noted following the intraoral sagittal split method. This did not influence the patient's satisfaction with the operation. The minimal postoperative scar following the extraoral oblique osteotomy was not a negative factor. Most patients underwent the surgical procedure for esthetic reasons. A large number (68 per cent) noted a change in personality postoperatively. A rationale for selective preoperative psychologic counseling is suggested.


Metastatic neuroblastoma in the mandible. Report of a case. The case reported here is that of a metastatic neuroblastoma of the mandible in a 5-year-old boy. This kind of metastasis in the mandible is very rare. Osteolytic jaw defects and unexplainable looseness of the deciduous molars in children should induce a thorough examination with the possibility of a metastatic malignoma in mind. A summary of the literature and prognosis of these tumors has been given.


Dental anomalies in the Rothmund-Thomson syndrome. Report of a case.


Oral lesions in psoriatic patients.

Oral lesions in psoriatic patients. Psoriasis  is a chronic, recurrent, inflammatory disease of the skin. The occurence of psoriatic lesions in oral mucous membranes is a subject of controversy, and some investigators have stated that such lesions do not occur at all. In the present investigation 100 psoriatic patients were examined for the presence of oral lesions. No patient exhibited oral lesions of psoriasis; however, there was a relatively high incidence of angular cheilosis (11 per cent), fissured tongue (6 per cent), and benign migratory glossitis (5 per cent). The possibility that benign migratory glossitis is an oral manifestation of psoriasis is discussed.


Hand, foot, and mouth disease.

Hand, foot, and mouth disease. Hand, foot, and mouth disease, also known as vesicular stomatitis with exanthem, is a vesicular disorder affecting both skin and oral mucosa. The disease is usually caused by Coxsackie virus A-16 and affects mainly children. The oral lesions may require differential diagnosis from other conditions, such as herpetic gingivostomatitis, aphthous stomatitis, and herpangina. Hand, foot, and mouth disease should not be confused with foot-and-mouth disease of cattle, which is rare in human beings and is not caused by Coxsackie virus.


The nonkeratinocyte intraepithelial cell population in lichen planus. An ultrastructural characterization of cells in gingival lesions. Lesions of gingival lichen planus were studied ultrastructurally to determine the types of cells, other than keratinocytes, present within the epithelial layer and the relationship of these cells to each other and to the keratinocytes. Cell types identified included small and medium-sized lymphocytes, macrophages, mast cells, and Langerhans cells. Some cells lacked sufficient specific features to permit definitive identification. The cells were found either singly or in groups. Generally, some alteration in the intercellular spaces between keratinocytes was apparent, even in regions where the mononuclear cells were absent or in the process of crossing the basal lamina. Most of the mononuclear cells had cytologic features which indicated that they were active cells. Occasionally lymphocytes appeared, on a morphologic basis, to be interacting with adjacent keratinocytes.


Electron microscopic study on the pathogenesis of recurrent aphthous ulceration as compared to Behçet's syndrome. In the prickle-cell layer of the oral epithelium of recurrent aphthous ulceration (RAU) the reticuloid cells with homogeneous, electron-lucent nuclei were attached to the degenerated prickle cells and ingested the cytoplasm of the prickle cells. The reticuloid cells came in contact with small lymphocytes, to which the immunologic information was transferred, inducing them to undergo blast transformation. Lymphoid cells, corresponding to T-cells, may produce a cytotoxic factor, since the prickle cells ultimately undergo degeneration. These changes are consistent with those of delayed hypersensitivity reactions. The cytoplasm of prickle cells apparently acts as an autoantigen. In Behçet's syndrome the macrophages were encountered in the epithelium. Other consequences were quite similar to those of RAU. The nucleus of the macrophage is more electron dense and has condensed chromatin along with the nuclear membrane. This can be a difference between Behçet's syndrome and RAU only at the initial stage of the diseases.


Ameloblastic fibro-odontoma. Report of seven cases.


Facial and oral manifestations in leprosy. An evaluation of seventy cases. A clinical and radiologic study of early and late manifestations in tuberculoid, dimorphous, and lepromatous leprosy was undertaken in order to determine characteristics, occurrence, and incidence of facial and oral lesions. Dermal, mucosal, neural, skeletal, and dental changes were correlated with the duration of leprosy, duration of treatment, and age of the patient.


Taurodontism. Report of sixteen cases in Israel. Taurodontism is generally considered a very rare dental anomaly in modern man. Sixteen new cases of taurodontism in Israel are described in patients presenting for routine treatment in a dental center. The majority of affected teeth occurred singly, and the mandibular second molar was the tooth most frequently involved. It would appear that taurodontism is a great deal more common than was previously thought. The clinical aspects of the condition are discussed with regard to endodontic and periodontal therapy.


Eosinophilic bodies in the epithelium of oral inflammatory hyperplastic lesions. Histopathologic and histochemical study. Four hundred twenty-three specimens of inflammatory hyperplastic lesions of the oral cavity were examined for changes in the epithelium. Amorphic eosinophilic material was found in the superficial layers of the epithelium in 12 per cent of the cases. The incidence and severity of the changes were related to the intensity of the inflammatory reaction in the underlying tissue. Histochemically, the material contained protein, disulfide and sulfhydryl groups, tryptophan, and carbohydrate.


Birooted mandibular cuspid.

Birooted mandibular cuspid.


Silicon carbide embedded in skin.

Silicon carbide embedded in skin.


Congenitally missing mandibular permanent central incisors.


Studies on the determinants of surface enamel fluoride and its relationship to dental caries.


Glycogen storage disease presenting as kwashiorkor.


Amantadine decreases d-amphetamine stimulation and increases d-amphetamine anorexia in mice. Amantadine hydrochloride (Symmetrel), an antiviral, antiparkinson agent that is most frequently used clinically at oral doses of 2 to 3 mg/kg, significantly decreased d-amphetamine-induced CNS stimulation (motor activity) and simultaneously increased d-amphetamine-induced anorexia (milk intake) in mice. Amantadine did this at oral doses of 2.5 and 5 mg/kg, which alone had no effect on either motor activity or milk intake.


Leukemia allotransplants in canine fetuses: influence of host age and immune responsiveness. Myelomonocytic leukemia cells allografted prenatally in some developing purebred Beagle fetuses elicited tumors postnatally in some of the pups. The later in gestation that the inoculum was delivered, the less was the disposition to eventual leukemia, indicating that fetal host age at the time of grafting and tumorigenesis are correlated. The leukemogenic transplants may have grown because of fetal immunoinsufficiency or because they were tolerogenic in the developing immune system. Limited immunologic data for exclusion of the latter possibility are reported.


The resistance of sheep to Fasciola hepatica: studies on the pathophysiology of challenge infections. Determinations of circulating eosinophils, plasma proteins and glutamate dehydrogenase, voluntary drymatter intake, and plasma loss in the faeces were carried out on three groups of sheep infected with Fasciola hepatica. One group was previously uninfected, one had been treated to eliminate a 15-weeklong preliminary infection, and one had previously been exposed to five infections each terminated after one week. Compared with the controls, both challenged groups showed earlier and greater peaks of eosinophils and the group previously exposed to multiple short-term infection showed a more gradual and persistent rise in glutamate dehydrogenase. The trends of plasma globulin suggested that an anamnestic response occurred only in the group which previously harboured adult flukes. The latter group also showed, at 12-14 weeks after challenge, the lowest intake of dry matter and the greatest loss of plasma in the faeces. At post mortem examination, similar numbers of flukes were recovered from challenged and control sheep. It was concluded that there was no evidence from the present experiment to show that preliminary infection of sheep with F hepatica conferred any significant resistance to the physiological effects of a challenge infection.


A message from the dean. Medical school admissions.


The president's page. There's no free lunch anymore!!


Editorial: Low dose heparin.

Editorial: Low dose heparin.


A serological profile in leprosy.

A serological profile in leprosy.


Familial leukaemia. A report of three cases of acute leukaemia in a Brazilian family. The authors reported of three individuals observations -- three siblings in a family -- of acute lymphoid leukaemia. Cytogenetic studies carried out in peripheral blood, lymphocyte cultures with PHA, in two patients and in several relatives, showed numerical and structural alterations. The third patient died before the cytogenetic studies were done.


Leukocytosis and fibrinolytic activity of the blood in leukemic patients. The relation between the levels of leukemic leukocytosis and blood fibrinolytic activity was studied in 58 patients with acute leukemia, 58 with chronic granulocytic leukemia, and 60 with chronic lymphocytic leukemia. In all these groups, high levels of leukemic leukocytosis were associated with increased blood fibrinolytic activity. Differences between patients with high and low values of leukocytosis were statistically significant.


The predominant cultivable organisms in juvenile periodontitis. Quantitative and qualitative examinations of the predominant cultivable microflora of the advanced tissue destruction (pocket) associated with juvenile periodontitis and of control pockets without loss of attachment were carried out by using anaerobic tube culture technique. The microflora from the control sites consisted primarily of streptococci, Gram-negative rods, and Gram-positive rods. In contrast, the test pockets had a relatively stable and characteristic microflora, dominated by various Gram-negative, anaerobic rods. The Gram-negative rods were divided into main groups, but a satisfactory classification of many of these microorganisms could not be performed with the methods used and the data available. The predominating Gram-negative rods differed from individual to individual. The role of the Gram-negative rods in the etiology of juvenile periodontitis is unknown. Some potential pathogenic mechanisms of these microorganisms are discussed.


Periodontal health following fibrotomy of the supra-alveolar fibers. A clinical follow-up study has been carried out in order to study the periodontal health of orthodontically derotated teeth where the supra-alveolar fibers have been severed by an incision through the bottom of the marginal pocket to the border of the alveolar bone in order to reduce the tendency towards a posttreatment relapse. The material consisted of 30 rotated teeth treated orthodontically in 27 patients between the ages of 9 and 22 years. Following an average retention period of 8.3 months, the supra-alveolar fibers were severed down to the alveolar bone border. The control material consisted of untreated, banded contralateral teeth in the same jaw. The patients were examined for plaque, gingival health and depth of the marginal pockets. No significant difference in periodontal health could be found on comparison between, on the one hand, teeth treated with fibrotomy and, on the other hand, untreated teeth.


Haemophili in developing dental plaque.

Haemophili in developing dental plaque. Evidence for a possible role played by oral haemophili in the development of dental plaque was sought by studying the occurrence of these bacteria in early dental plaque of smooth surfaces and occlusal fissures in six dental students. The mean number of haemophili per 10(3) anaerobes in early smooth surface plaque (18 h) and fissure plaque (7 d) was 95 and 22 respectively. Examination of 988 Haemophilus isolates revealed that H. parainfluenzae was the only species in samples of fissure plaque, whereas some samples from smooth surfaces, in addition to the predominating and ubiquitous H. parainfluenzae, yielded growth of the two species H. segnis and H. aphrophilus. It is concluded that haemophili are among the primary colonizers of smooth surfaces of teeth.


Effect of formaldehyde-containing drugs on human dental pulp evaluated by enzyme histochemical technique. The in vivo effect of formaldehyde on pulp tissue in short-term studies cannot be established by using routine histologic techniques because the tissue is exposed to a fixative in vivo as well as during the histologic preparation. The pulps of permanent premolars were amputated and zinc oxide with 4% formaldehyde or formocresol was used as wound dressing. The observation periods varied from 1 to 16 d. After extraction the teeth were freeze-sectioned, freeze-dried and then incubated for histochemical demonstration of some oxidative and hydrolytic enzymes. A demarcated border between apically stained and cervically nonstained pulp tissue was found in sections incubated for oxidative enzymes. When formocresol, which has a high concentration of formaldehyde, was used, the border was situated closer to the apex. This was also the case when the observation period was increased. The incubation for lactate dehydrogenase gave a high staining intensity. Thus the use of frozen sections in combination with the histochemical method for the demonstration of lactate dehydrogenase appears to be suitable for the study of the penetration of formaldehyde in pulp tissue in short-term studies.


Deformation of cavities and resin fillings in loaded teeth. The purpose of the present work was to study (1) the deformation of selected types of cavities in axially loaded human teeth and (2) the possible effect of this deformation on the restorative quality of fillings in the cavities. Recently extracted wet teeth without any visible structural defects were used throughout the study. Standard Class III and large Class III cavities were prepared in maxillary incisors, while Class I, m-o, m-o-d, and Class V cavities were made in maxillary first premolars. For the second part of the study several of the cavities, etched of non-etched, were filled with restroative resins. Mounted in a measuring microscope the teeth were loaded in a way simulating biting or chewing; cavities with fillings were accepted only when no marginal gaps could be found. The results showed a deformation of empty cavities proportional to the load up to 16 kg, the decrease or increase in diameter being 0.1-1.0 mum/kg, depending on the type of cavity. Loading and unloading of teeth with filled cavities resulted in permanent or transitory gaps. The dimensional instability of cavities in loaded teeth indicates a severe risk of percolation by several restoratives and of marginal fracture of brittle fillings.


Non-random and random chromosomal abnormalities in transformed chronic granulocytic leukaemia. Chromosome abnormalities, identified using a banding technique and additional to the Ph, are reported in 10 consecutive cases of transformed chronic granulocytic leukaemia. In most of the cases the abnormalities were non random. In 2 cases serial studies were performed and additional abnormalities found, antedating transformation by one week and two months respectively. In 2 others the Ph status had been established during the chronic phase of the disease. In the remaining cases the first chromosome analysis was performed at the time of transformation.


Problem solving in diagnostics and therapeutics of neurology. A series of 24 lectures. Lecture No. 5. Midline lesions of the brain.


Legislative changes regarding malpractice.


A comparison of health problems in comparabile groups of Indian and white adults; particularly diabetes, oral anti diabetic medications and peripheral vascular disease.


Aortic aneurysms--advances in diagnosis and treatment.


Some attributes of patient satisfaction.


Traumatic rupture of the thoracic aorta.


Irritative lesions of the central nervous system.


Secondary gout associated with chronic myeloproliferative disorders.


[Disinfection and sterilization in stomatological practice].


The medical examiner system: a new concept in community medicine for the state of West Virginia.


Acute spinal epidural abscess.

Acute spinal epidural abscess.


Congenital sarcoma of the hand (a case report).


Aplastic anemia: a serious complication of viral hepatitis.


Optometry--a new medical specialty?

Optometry--a new medical specialty?


Editorial: Corneal arcus and cardiovascular disease.


Editorial: Mortality among medical students and young physicians.


Physicians' seminars to explore link with the humanities.


Address by L. M. Kennedy, D.D.S.

Address by L. M. Kennedy, D.D.S.


Effects of using various types of dental floss on gingival secular bleeding.


Preventive dentistry--new concepts. Flexibility in the control program.


Continuing dental education in Virginia.


Preventive dentistry--new concepts. Preventing periodontal pockets.


Restoring teeth with large complex amalgams rather than castings.


Preventive dentistry: nutrition and oral health.


The role of the general practitioner and the dental hygienist in an oral cancer control program.


Toluidine blue and lip lesions.

Toluidine blue and lip lesions.


Psychological consideration for the dentist with cancer patients.


Feasibility study in Virginia for taking continuing education to dental practitioners in their own localities: a report.


Questions for self-evaluation operative dentistry.


Jejunal transposition in stomach surgery: indications and results.


Studies in diagnostic ultrasound. Size of the non-pregnant uterus in women of child-bearing age and uterine growth and foetal development in the first half of normal pregnancy.


Induction of ovulation.

Induction of ovulation. Ovulation has been induced by clomiphene citrate and human gonadotropins in infertile women. Clomiphene should be the first choice in anovulatory women with active ovaries as indicated by basic levels of estrogens in blood or urine, in women with post-pill amenorrhea even if their ovaries are quiescent and in women with functional abnormalities of the hypothalamus or pituitary. Human gonadotrophins should be used as a second alternative when clomiphene fails. It should also be used as a first choice in women with primary amenorrhea and quiescent ovaries and in women with gross anatomical changes in the pituitary or hypothalamus. If no result is obtained after two courses of gonadotropic therapy, further treatment should be reconsidered and the infertile couple reinvestigated.


Side-effects of acrylic cement implanted into bone. A histologicl, (micro)angiographic, fluorescence-microscopic and autoradiog-aphic study in the rabbit femur.


Effects of major resection of the sacrum. Clinical studies on urogenital and anorectal function and a biomechanical study on pelvic strength.


The halo-pelvic apparatus. A clinical, bio-engineering and anatomical study.


2,3-diphosphoglycerate levels in children with iron deficiency anemia and acute leukemia.


Experimental aural barotrauma. Electrophysiological and morphological findings. The electrophysiological findings show a time and pressure related decrease in function of the CM and the N1 potentials. Sudden changes were correlated with tympanic membrane perforations. Some of the decreased function is accounted for by middle ear effusion and hemorrhages, reducing mechanically the transmission of sound energy through the middle ear. This was evidenced by an improvement of function when the fluids were removed. Remaining decreases in function were interpreted as a result of influences on the inner ear function or of undisclosed middle ear changes. No differences were noted in cochlear function between animals subjected to sustained or intermittent middle ear pressures. Neither were any morphological differences noted between these two groups in the middle or inner ear. The morphological middle ear findings correlated well with previous clinically and experimentally induced changes with increased/decreased middle ear pressure. The cochlear findings include the interesting observation of an intact round window membrane, a clear endolymph, and a normal Organ of Corti in all cases. Positive findings were a high frequency of hemorrhage, most commonly demonstrated in the scala tympani of the basal turn close to the round window. The origin of the hemorrhages could not be demonstrated with the present investigation. The hemorrhages often appeared to be related to the cochlear aqueduct. The occurrence of hemorrhage was clearly related to increased negative pressure, and the non-existence of hemorrhage was always related to either tympanic membrane perforations or low applied pressure. Further frequent findings were distention, collapse, and rupture of the inner ear membranes which must be interpreted with great circumspection due to the method used. Likewise, some of the pathological cochlear findings may be due to pathological conditions which are not necessarily related to induced middle ear pressure.


Morphological effects of rapeseed oil in rats. II. Long-term studies. In long-term studies covering up to 160 days young Sprague-Dawley rats were fed diets containing 40 cal% of fat. The fat component consisted of either conventional rapeseed oil, or Canadian rapeseed oil low in erucic acid, or arachis oil. Myocardial fatty accumulation was demonstrated in light microscopic studies throughout the experiments in rats fed conventional rapeseed oil, but the number of fat droplets decreased with time. The controls fed arachis oil showed no fatty accumulation. In the rats fed conventional rapeseed oil focal myocardial lesions appeared after 40 days on the diet. These consisted of histiocytic infiltration, occurrence of macrophages, myolysis, proliferation of fibroblasts and finally scarring. Such foci were found widely spread in the myocardium of these rats. In the experimental groups given Canadian rapeseed oil from the cultivar Oro no histiocytic foci or scarring were observed. Small myocardial lesions were occasionally found in the control rats. These latter findings were observed on serial sections. It was concluded that this type of lesion is a "normal" finding. The number and size of the foci observed in animals fed conventional rapeseed oil (10% and 2% (w/w) erucic acid in the diet) indicate, however, that they have to be considered pathological under such circumstances. The pathogenesis of the myocardial alteration is discussed and it is concluded that the long-chain fatty acids are responsible. No direct proof has been presented that the described events are of importance in human pathophysiology, However, several circumstances pointing in this direction are discussed. It is concluded that on the basis of our present knowledge a pathological effect of erucic acid and its homologues in man cannot be excluded.


Morphological effects of rapeseed oil in rats. III. Studies in germ-free rats. The morphological effects on the myocardium of feeding rapeseed oil were compared in conventional and germ-free rats in short-term experiments (10 days). It was concluded that the fatty accumulation in the heart muscle cells occurring in rats fed rapeseed oil was not influenced by the presence or absence of a normal intestinal flora. In long-term experiments (80 days) under similar conditions, the myocardial effects of feeding germ-free rats with conventional rapeseed oil, rapeseed oil from the Canadian cultivar Oro very low in erucic acid, or arachis oil were studied in serial sections. Severe myocardial lesions developed in the group of rats fed conventional rapeseed oil, while in the other two groups the myocardium was completely normal. These results give no support to the theory that other factors than C22:1 acids in rapeseed oil are responsible for the myocardial lesions.


Morphological effects of rapeseed oil in rats. I. Short-term studies. Light microscopy of paraffin embedded and frozen sections, supplemented with electron microscopy, was performed on the heart muscle of young rats fed rapeseed oil in short-term experiments. It was confirmed that high levels of rapeseed oil, which contains erucic acid, produce severe lipoidosis of the heart muscle fibres within 10 days. An attempt was made to find out the lowest level of erucic acid in the rat diet to give rise to pathological fatty accumulation. Several frozen sections from each heart or serial sections in combination with electron microscopy were used for this evaluation. The level found to give rise to pathological fatty accumulation was about 2% by weight (w/w), while rats fed 1% erucic acid showed normal myocardium. No direct proof that erucic acid is of importance in human pathophysiology has hitherto been presented. It is concluded, however, that the similarity in reaction among the many species of experimental animals tested by different workers, as well as the basic metabolic disturbances demonstrated, are in strong favour of a similar effect in man.


Electrocardiogram and renal concentrating capacity in rats fed a diet containing rapeseed oil. The functional effects of a diet containing rapeseed oil (40% of total energy intake) were studied in rats, starting at age 28 days. There were no effects on the electrocardiogram in spite of morphological changes in the myocardium. In 10 female rats the urine osmolality following 16 hours of dehydration was approximately 20% lower than in 10 control rats during the 9th, 10th and 20th week of the experiment. It is suggested that erucic acid in the rapeseed oil inhibits beta-oxidation of fatty acids in the kidney, thereby depriving the kidney of energy involved in sodium transport.


Studies of the mode of action of erucic acid on heart metabolism. The effects of erucic acid on the oxidative metabolism of rat-heart mitochondria have been investigated using intact animals, perfused beating heart, isolated mitochondria and mitochondrial extracts. Feeding rats with a diet containing erucic acid was found to lead to a diminished ability of the isolated heart mitochondria to oxidize various substrates, in accordance with previous reports (Houtsmuller et al., Biochim. Biophys. Acta 218 (1970) 564). This effect was almost pronounced with palmitylcarnitine as substrate, in which case the rate of oxidation was decreased by more than 50% at such a low erucic acid content in the diet as 1.4% given over 2-4 weeks. Oxidation of palmitylcarnitine was also found to be inhibited when erucylcarnitine was added to isolated heart mitochondria from control animals, in agreement with earlier observations (Christophersen and Bremer, FEBS Lett. 23 (1972) 230; Biochim. Biophys. Acta 280 (1972) 506). The inhibition was accompanied by a decrease in the rate and extent of reduction of mitochondrial flavoprotein. Experiments with perfused beating rat-heart likewise revealed an inhibition of flavoprotein reduction, as well as nicotinamide nucleotide reduction, when erucate was added to the perfusing medium of the beating heart respiring with oleate--but not with octanoate--as substrate. These data together with those earlier published in the literature indicate that erucic acid may interfere with the enzyme system involved in the mitochondrial oxidation of long-chain fatty acids, probably at the level of acyl-CoA dehydrogenase. Kinetic data supporting this conclusion, obtained with extracts of rat-heart mitochondria containing the acyl-CoA dehydrogenase and electron-transferring flavoprotein system, are presented. The possible implications of these results for the known effect of dietary erucic acid in causing an accumulation of fat in the heart are discussed.


Observations on lipid composition with particular reference to cardiolipin of rat heart after feeding rapeseed oil. The influence of dietary rapeseed oil on the lipid classes and fatty acid pattern of rat heart homogenate and mitochondria has been investigated after feeding a diet with 9.8 weight- % erucic acid for 10 days and 1.4 and 2.6% erucic acid for 28 days. The rats treated with 9.8% erucic acid showed a significant increase in the triglycerides of the heart mitochondria. This tendency was much less pronounced in rats treated with 1.4 resp. 2.6% erucic acid. These results confirm those of other investigators. A slight increase in the cholesterol esters of the mitochondria could be seen in all the treated rats. The total phospholipids were decreased in the experiment with 9.8% erucic acid and slightly increased in experiments with 1.4 and 2.6% erucic acid. The concentration of phosphatidylcholine showed a tendency to increase and the concentration of phosphatidylethanolamine to decrease in the experiment with 9.8% erucic acid in the diet. The concentration of cardiolipin was mainly unchanged. In all experiments the triglycerides of the heart mitochondria showed a high content of erucic acid. The fatty acids of the cholesterol esters of the heart mitochondria were also influenced of dietary rapeseed oil but to a less extent than the triglycerides. The fatty acids of phosphatidylcholine, phosphatidylethanolamine and cardiolipin were all influenced by the dietary rapeseed oil, but the erucic acid seemed to have a specific affinity to cardiolipin. Cardiolipin of rat heart mitochondria was isolated and identified with gas chromatography and mass spectrometry. The isolated cardiolipin was found to contain 12 per cent erucic acid after feeding 9.8% erucic acid as rapeseed oil for 10 days. Similar results were obtained after feeding glyceryl trierucate for 5 days to rats. The incorporation of erucic acid into cardiolipin was followed by a corresponding decrease of linoleic acid. This observation is of great interest because the molecular structure of fatty acids in lipid molecules has a profound influence of the packing of these molecules in a bilayer. Since cardiolipin is a component of the inner membrane of mitochondria its high affinity for erucic acid might influence the normal function of the inner membrane of heart mitochondria.


Effects of anoxia and severe ischemia on the turnover of myocardial proteins.


The use of hyaluronidase and hydrocortisone in the reduction of myocardial infarct size following coronary occlusion. Experimental and clinical observations.


Effect of substrate on enzyme release and electron microscopic appearances after coronary artery ligation in isolated rat heart.


Applications and limitations of estimation of infarct size from serial changes in plasma creatine phosphokinase activity.


The role of myocardial membrane lipids in the development of cardiac necrosis. 1. The fatty acid composition of cardiac membrane lipids is influenced by age, sex, diet and other factors. 2. The relative amounts of various polyunsaturated fatty acids in cardiac lipids influence markedly the development of myocardial necrosis and mortality following overstimulation with isoproterenol. 3. The availability and metabolism of arachidonic acid may play an important role in regulation of cardiac metabolism.


Propranolol in acute myocardial infarction in man. Effects of hemodynamics and myocardial oxygenation.


Effect of cardioselective beta-blockade on heart function and chest pain in acute myocardial infarction. Systolic time intervals and the a/H ratio were recorded in 20 patients with uncomplicated acute myocardial infarction over a period of five days. The initial high heart rate and systolic blood pressure and the short PEP and ICT indicating a sympathetic overactivity were spontaneously normalized during the first week of infarction. LVET was reduced indicating a fall in stroke volume and the a/H ratio was unchanged at the high levels suggestive of elevated preload or LVEDP. In 10 patients with acute myocardial infarction and recurrent chest pain recordings on noninvasive parameters were made before and 30 min after intravenous injection of practolol. In addition, 7 patients with chest pain, classified as acute myocardial infarction, were given practolol. The average dose of practolol was 17.9 mg ranging from 5 to 30 mg. An almost immediate and pronounced relief of pain was observed in all patients and no signs of impaired left ventricular function appeared. The product of systolic blood pressure and heart rate was decreased by practolol and the PEP and the ICT were prolonged to normal values while no changes were seen in LVET and a/H ratio. On 126 occasions practolol was given in dosages ranging from 5 to 30 mg (mean 8 mg) to 75 patients with acute myocardial infarction and recurrent chest pain. A satisfactory pain relief was seen on 108 occasions. It is suggested that an inappropriate sympathetic overactivity is an important factor in provoking recurrent chest pain in acute myocardial infarction. Administration of the beta-adrenergic blocking agent practolol resulted in pain relief due to reduction of heart work and in severity of myocardial ischemia. The beta-blocking agent was well tolerated in the present study. Continuous beta-blockade during the whole hospital stay to patients with acute myocardial infarction seems to be a very attractive therapy in order to preserve the ischemic myocardium and limit the size of infarction.


The importance of mechanical performance for development of myocardial infarction in man. In studies using an experimental infarction as a model it has been shown that factors increasing myocardial oxygen consumption will increase the size of infarction, while factors reducing the oxygen consumption have the opposite effect. The presence of catecholamines might be most important. It is suggested that local release of noradrenaline from the sympathetic nerve endings in ischemic myocardium can induce vigorous contractions and deleterious ischemia and result in cellular necrosis. A retrospective study was performed in 81 patients hospitalized in Göteborg in 1964-1965 due to attacks of severe chest pain with no previous documented myocardial infarction. In 31 of these patients definite congestive heart failure was seen at hospitalization or developed later. During 10 years of follow up the mortality was 48 per cent and an acute myocardial infarction was found in 64 per cent of the patients without congestive heart failure. In patients with congestive heart failure the mortality was 42 per cent, and 6.4 per cent had an acute myocardial infarction. The poor mechanical performance and a lower myocardial content of noradrenaline of the failing heart might protect from the acute myocardial infarction and instead be predisposed to a slow degeneration, pump failure, and serious arrhythmias. Severe angina pectoris and congestive heart failure might represent opposite ends of the spectrum of ischemic heart disease with similar degrees of luminal narrowing of the coronary arteries.


Effect of reduction of myocardial free fatty acid metabolism relative to that of glucose on the ischemic injury during experimental coronary artery occlusion in dogs.


Factors modifying ischemic alterations of ventricular function and metabolism in the intact working swine heart.


Use of baboons in studies of acute myocardial infarction and effects of infusions of glucose, insulin and potassium (GIK).


Cell volume regulation in acute myocardial ischemic injury. Thin freehand slices of left ventricular papillary muscle of the dog, exhibit good cell volume regulation when incubated at 37 degrees for 60 minutes in oxygenated Krebs Ringer phosphate solution. The fine structure of the cells is maintained throughout the incubation. This in vitro system was developed in order to test the capacity of myocardial cells irreversibly injured by 60 minutes of ischemia to maintain cell volume. The results showed that irreversibly damaged cells were unable to maintain volume. They swelled markedly, lost Mg2+ and K+ and exhibited structural defects in the plasma membrane of the sarcolemma. These observations establish that loss of cell volume regulation is one of the early events associated with the development of irreversibility in severe myocardial ischemic injury.


Effects of lipolytic and inotropic stimulation on myocardial ischemic injury.


Rate-limiting steps of carbohydrate and fatty acid metabolism in ischemic hearts. Control of glycolysis and fatty acid oxidation in ischemic myocardium was studied in isolated working rat hearts. Coronary flow was reduced to the whole heart. In ischemic tissue, oxygen consumption, glycolysis and fatty acid oxidation all decreased in proportion to the restriction in coronary flow. Inhibition of glycolysis developed at the level of glyceraldehyde-3-phosphate dehydrogenase. Restricted flux through this step appeared to result from accumulation of lactate, H+ and NADH. The rate of glycolysis was inversely related to accumulation of lactate. Additions of high levels of lactate to the perfusate inhibited glycolysis in aerobic, anoxic and ischemic hearts. The mechanism of this effect of lactate in anaerobic hearts is unknown, but does not appear to be related to pH changes. Oxidation of fatty acids was restricted at the level of beta-oxidation and high levels of both long-chain acyl CoA and carnitine derivatives accumulated.


Topography of internal organs of reindeer (Rangifer tarandus). Topographic anatomy applied in the hunting of reindeer.


Blast crisis as an initial or terminal manifestation of chronic myeloid leukemia. A study of 28 patients. The clinical and morphologic features of nine patients who initially presented with blastic leukemia and the Philadelphia chromosome were studied. Corresponding features were evaluated at the time of diagnosis of blast crisis in 19 patients who had a previous history of chronic myeloid leukemia (CML). Although many of the presenting symptoms and signs were similar, infections, lymphadenopathy, tissue infiltration and central nervous system involvement were more common in patients who presented with blastic leukemia. Marked leukocytosis, basophilia and marrow hypercellularity were present in both groups. Although patients in both groups had morphologic patterns that resembled acute leukemia, cytology suggestive of acute lymphocytic leukemia was more frequent in patients who initially presented with blastic leukemia. Megakaryocyte, platelet and erythroid abnormalities were more frequent in patients with a prior history of CML. Although there were clinical and morphologic features in the patients who presented with blastic leukemia which suggested the diagnosis of CML in blast crisis, chromosome studies were necessary to identify some of these patients. In both groups of patients multiple therapeutic regimens were used. Complete remissions were obtained in two patients; both presented with blastic leukemia, had "lymphoblastic" morphology and were treated with chemotherapeutic agents generally used for the treatment of acute lymphocytic leukemia. It appears that morphology of the blast crisis may be important in choosing the treatment regimen.


Carcinocythemia (carcinoma cell leukemia). An acute leukemia-like picture due to metastatic carcinoma cells. Observation of a unique population of cells on a Wright-stained blood smear of a patient with metastatic breast carcinoma prompted a study to determine their origin. The primary carcinoma contained a marker, the presence of "signet cells." These were demonstrated in direct peripheral smears and buffy coat preparation of peripheral blood and confirmed histochemically by showing positive periodic acid-Schiff, alpha-napthol and beta-glucuronidase reactions. "Carcinocythemia" is suggested as a name for this unusual process observed over a six month period. Studies of the patient's immunocompetence, of circulating cell surface immunoglobulins and karyotype analysis were made. Postmortem examination revealed retroperitoneal fibrosis, splenic atrophy and extensive metastatic carcinoma but no evidence of leukemia. The cells will be contrasted to those seen in a second patient who appeared to have acute myelocytic leukemia complicating extensive cancer involving the bone marrow. The observations suggest that a leukemia-like blood picture due to circulating cancer cells may occur during the course of metastatic breast carcinoma.


Simulated near-in fallout in goats and its effects.


Letter: Sex selection.

Letter: Sex selection. The sex ratio and the possibility of the determination of sex prior to conception are discussed.  Fluorescence microscopic examination of spermatozoa stained with fluorochrome quinacrine has revealed that the smaller-headed sperm contains the Y-chromosome.  The frequency of Y-bearing spermatozoa in human samples has been reported to be 66%.  A differential filtration frequency of 96-98% for passage of Y-sperm into optimal cervical mucus has also been reported.  The average sex ratio is about 100 females:105-107 males, though ratios at least as high as 100:150 have been found in certain cultures.  The chances for conceiving a male offspring are highest when the cervical milieu is optimal for conception.  Since male siblings are often valued more than females in many cultures and religions, the ability to select the sex of offspring could have salutary effects on problems posed by high birthrates.


A study of the anterior portion of the palate as it relates to orthodontic therapy. 1. The anterior portion of the palate does not appear to move lingually as orthodontic forces move incisor teeth lingually. Although the alveolar bone directly supporting the teeth can be moved distally (and elongated), it does not appear possible to move the apex of the root more distally than the pretreatment position of the palatal plate. Thus, there appears to be an anatomic limitation to the distal movement of maxillary incisor teeth. 2. When incisor teeth are moved distally within the boundaries of the present alveolar process, the supporting bone does not remodel to the roots' new position; when a root which was initially positioned nearer the labial alveolar plate is moved distally against the palatal plate, there was observed no adaptation in the bone to have the root once again located near the labial alveolar plate, the root remained stable against the palatal plate. 3. When great distal movement of incisor teeth results in an alteration in position of the supporting alveolar bone, remodeling of the bone maintains a relatively constant labiolingual width of this alveolar bone. The new position of the tooth and supporting bone appears to be stable. 4. The scanty metallic implant evidence would seem to support histologic observations that alveolar processes are remodeled by apposition of bone on the cortical plate toward which the tooth is moving and resorption of the cortical plate away from which the tooth is moving. 5. There does not appear to be a statistically significant correlation between posterior facial measurements (SNMP) and the labiolingual width of the anterior palate.


Begg-edgewise, an amalgamated technique.


American Association of Orthodontics. The future of the Long Range Study Committee.


Conservative treatment of palatally impacted canines.


Editorial: FTC complaint centers on AMA advertising limitations.


Constituent Society presidents report on current orthodontic issues. Part II.


The psychedelic model of schizophrenia: the case of N,N-dimethyltryptamine. The authors review the research on N,N-dimethyltryptamine (DMT) as a possible "schizotoxin." DMT produces psychedelic effects when administered to normal subjects, the means are present to synthesize it in man, it has occasionally been found in man, and tolerance to its behavioral effects is incomplete. However, DMT concentrations have not been proven to differ significantly in schizophrenics and normal controls. Also, in vivo synthesis of DMT has not been convincingly demonstrated, and the psychological changes it produces do not closely mimic the symptoms of schizophrenia. The authors conclude that more data are necessary before the validity of this theory can be determined.


A new compact, versatile, fluidic controlled ventilator.


Letter: An unexpected hazard of the Boyles machine.


Letter: Design of the Boyle adsorber.

Letter: Design of the Boyle adsorber.


New perspectives on orientation and their benefits to clinical orthodontics--part II. As composites were compared from the frontal and lateral, the organization tended to point to orientation of growth of cavities in the face from the divisions of the fifth nerve. Three-dimensional constructed capsules of the orbital, nasal and oral cavities may be reduced to the inputs from the entrance of these nerves into their appointed functional matrices. These orientations were found to be so useful and beneficial that they have been adopted for computer functions. They have also been found fruitful for prediction.


Dental development in cleft and noncleft subjects.


Periodontal status of orthodontically treated impacted maxillary canines. Thirty-four unilateral palatal impacted maxillary canines were brought down by orthodontic means after a radical surgical exposure. The contralateral canines which had erupted unaided served as controls during the study. Measurements of the gingival pocket depths showed that the distal pocket on the treated teeth was significantly deeper than on the control teeth. The treated canines displayed significantly more loss of periodontal support on the buccal and palatal surfaces than did the untreated teeth. Radiographically, there was more alveolar bone loss on the mesial surfaces of the corrected than on the uncorrected canines, the mean distance being 2.06 and 1.51 millimeters, respectively. The age of the patients at the start of treatment did not seem to have any profound influence on the loss of attachment, but the individual variation was considerably greater in adults.


A radiographic study of roots in extraction sites. 1) Roots that are overparalleled to the extent that the apices touch do not relapse to the desired upright positions. 2) Roots that are overparalleled, but the apices do not touch, tend to upright but, in so doing, leave space between the crowns. 3) Roots that are underparalleled at the completion of active treatment tend to maintain their positions or diverge even farther. 4) The best postretention results were cases in which roots and crowns were positioned in normal, upright parallel positions. Slight spaced remaining in these situations appeared to close evenly.


Occlusion: Understanding or misunderstanding.


Emotional stress during retention and its effect on tooth position.


Selection of dentofacial measurements for an orthodontic treatment priority index. A battery of thirty dentofacial measurements was studied in an attempt to identify those measurements most closely related to a clinical assessment of the need for orthodontic treatment in the Dutch population. This was done by inspecting the mean values of these measurements computed within several treatment priority groups, a stepwise regression analysis relating treatment priority scores to these dentofacial measurements, and a quadratic discriminant function analysis between the group of children requiring orthodontic treatment and the group for which treatment was deemed unnecessary. The variables identified by inspection were 1) overjet, 2) overbite, 3) upper molar arch width, 4) the angle defined by articulare-gonion-menton, 5) lower arch length and 6) the ANB angle; the first four of these proved to be the most important when the contributions of all thirty of the variables to the TPI were assessed by means of the stepwise regression analysis. Overjet was also found to be an important predictor variable by Freer in relating Grainger's orthodontic TPI to dentofacial measurements in a group of patients with distoclusion; the ANB angle was found to be the most effective discriminator between normal and Class II American children. The results of the present study then, to this extent at least, agree with those found in other populations. It would appear that any "universal" TPI would have to involve those aspects of dentofacial morphology measured by overjet and the ANB angle. Within the context of the Dutch population the variables identified proved to be effective discriminators in the decision of "to treat or not to treat," correctly classifying 100% of the children in the sample who were judged by two experienced orthodontists as requiring treatment. While this decision rule did suggest treatment for 17% of the children judged to not require treatment, these cases were in the "doubtful" category (Table I) and might therefore warrant continued monitoring before any final decision is reached.


World priority number one: population and subsistence.


On the working environment.

On the working environment.


Respirator brain. Report of a survey and review of current concepts. Because of renewed public and scientific interest in the concept of brain death and its diagnostic criteria, an opinion survey was undertaken, polling the membership of the American Association of Neuropathologists, regarding the definition, gross and microscopical features, and pathogenesis of the syndrome popularly designated the "respirator brain." Of the 191 respondents who completed the questionnaire, 174 (91%) indicated that the term respirator brain is properly used to describe a specific pathological entity, and 160 (84%) considered the characteristics of respirator brain to be distinct from those of late fixation. Of the 174 respondents who accepted the designation, 148 (85%) regarded a history of respiratory dependency as essential, and a vast majority (95%) agreed that extensive tissue necrosis occurs with little inflammatory cell reaction; other criteria were more controversial. Microscopical changes that suggest a pathogenetic mechanism attracted a number of informative, limiting, or qualifying remarks. Nonetheless, 54% thought that impaired cerebral blood flow contributed to pathogenesis.


The psychiatrist in the surgical intensive care unit. II. A consideration of staff roles. The stresses present within the Surgical Intensive Care Unit (SICU) affect both patients and staff. The liaison psychiatrist attached to the unit helps in identifying and neutralizing tension displaced from its source. Death, although commonplace on the unit, often engenders strong feelings in the staff. Pulmonary patients, especially those who must be weaned from the respirator, also increase the psychological strain on the staff beyond the necessary effort involved in physical caretaking. Aside from emotional difficulty presented by working with very sick patients, there exists group pressures resulting from hierachy within the staff. Here, particularly, the psychiatrist can promote understanding and reduce polarization.


Mankind, its numbers, health, and family arrangements: group report 3. The population problem is an imbalance between numbers of people and limited resources.  The resources of food, energy, and living space have been well documented as finite in a world with population expanding geometrically.  Terrorism, breakdown of social order, and other social symptoms may also stem from this overcrowding.  The economically more affluent nations are attempting to deal with unregulated fertility by developing and spreading information on means of conception control and granting equality of status to women to compensate for the reduction in the  childbearing role.  Social systems are very complex and changing the desire for children is quite difficult.  In addition, people have a great capacity for ignoring potential disaster when surrounded by it.  Liberty of the individual and control must be kept in balance.  It is recommended that more effort be made to understand the motivations behind human reproduction and what social incentives exist to reduce family size.  There is also need for contraceptive technology and for more effective dissemination thereof.  Values and attitudes need to be changed and the mechanisms of communication, the institutional and organizational structures operating in the field of reproductive behavior, and the role of policy determination by the nation need to be  studied.  There is need for fertility control in conjunction with mortality control.  The committee believes that basic minimum components of the quality of life may be imposed upon a people if necessary in order to preserve the diversity of cultural and individual differences.


The world food crisis: projections, models, and paradigms.


Experience in the use of central venous cannulation. Experience in the placement of central venous cannulae is reported. Sixty patients underwent 67 cannulations, 62 by the supraclavicular approach. The advantages of this approach were speed and reliability of placement and a low incidence of complications. A pneumothorax in an emphysematous man was the only major complication.


Survival of dogs subjected to profound hypothermia with circulatory support. Thirty-one anesthetized dogs were surface cooled at 5 C and rewarmed after a variable period. Respiration was controlled with a volume respirator. When cardiac arrest occurred, circulation was provided with the mechanical ventricular assistance (MVA) device in 23 dogs. Of the animals maintained for four hours below 10 C on the MVA, 83% were successfully resuscitated. None of the dogs maintained for two hours below 10 C without circulation could be resuscitated. Eleven dogs were studied for a long-term survival after chest closure. Only four of them survived longer than three days. Death after rewarming was due to severe pulmonary insufficiency. Results of this study suggest that provision of oxygenation and a pulsatile circulation during hypothermia improve tissue viability of nonhibernators. The model shows potential for in situ preservation of multiple organs in the cadaver.


Non-familial vitamin D-resistant hypophosphataemic osteomalacia of adult onset: case report. An unusual form of osteomalacic bone disease in a middle-aged woman with a three-year history of widespread bone pain, pathological fractures and loss of height is discribed. Investigations revealed a persistent hypophosphataemia and an increased phosphate excretion index. Urinary glycine excretion was increased. An oral phosphate supplement led to rapid improvement. The features support the diagnosis of non-familial adult onset vitamin D-resistant hypophosphataemic osteomalacia.


Editorial: Middle age looks ahead.

Editorial: Middle age looks ahead.


Editorial: Deaths in infancy.

Editorial: Deaths in infancy.


Letter: Trends in rheumatic fever.

Letter: Trends in rheumatic fever.


Letter: Viral gastroenteritis in children.


Doctors of the future: some dilemmas in medical education.


Mortality patterns in acute coronary heart disease in New Zealand. An analysis has been made of death certificate information from 4885 persons classified as having died from acute myocardial infarction or other acute or subacute forms of ischaemic heart disease. One-third of non-Maori deaths occur in a public hospital and half the deaths occur at home. One-third of the deaths occur within five minutes, half within one hour, and by 24 hours, two-thirds of all those who die within two months of an acute coronary heart attack, have already died. Sudden death is more common in the elderly and far more common in those who die outside hospital. Post-mortems were performed in approximately a quarter of the patients. In public hospitals, 36 percent of non-Maoris had a post-mortem examination and 10 percent of Maoris.


Public opinion and legal abortion in New Zealand. In 1972 and 1974 opinions on legal abortion were surveyed over national random probability samples each of 2400 respondents aged 15 years and above. Both surveys found majorities favouring certain specific grounds for legal abortion. Some of these reasons approved by the majority are not legal under present law. There is a general consensus in the rank ordering of acceptability of grounds for legal abortion. Polarised minorities of respondents favour absolute legality or illegality of abortion. There has been a swing away from extreme pro- or anti-abortion sentiment to selective support for legal abortion on specific grounds.


The driniking driver: a blueprint for some further action. Statistical information relating to the offence of drunken driving in New Zealand is reviewed. The relationship between alcoholism and this offence is discussed. Two groups of offenders who should be dealt with separately can be identified. A plan is put forward with an outline of methods which could be used for dealing with this problem.


A spectrum of iodine malnutrition and its management: studies in the Tigris River basin.


Letter: Cortisol levels.

Letter: Cortisol levels.


Editorial: Dental anaesthesia.

Editorial: Dental anaesthesia.


Some clinical features of vulvovaginal melanomas with case reports.


Anomalous origin of left coronary artery from pulmonary artery: Report of a case associated with an atrial septal defect.


Assessment of vitamin B12 absorption in tropical sprue utilizing a whole body counter.


Diffuse esophageal spasm.

Diffuse esophageal spasm.


Focal nodular hyperplasia of the liver. Case report with unusual radiographic presentation.


Trichophytobezoar of the entire small intestine: Report of a rare complication.


Retrosternal goiter.

Retrosternal goiter.


The early eruption of a superanumerry tooth (mesiodens).


Dental dysplasia in incontinentia pigmenti achromians (Ito). An unusual form.


Dentinogenesis imperfecta. Report of a 5-generation family.


Cytotoxic effects on splenic ultrafiltrates upon leukaemic lymphocytes. Ultrafiltrates from spleen inhibited both DNA synthesis and the proliferation of normal lymphocytes stimulated inculture from both mouse and man without apparent cytotoxicity. However, the same doses of this spleen ultrafiltrate will kill up to two-thirds of the leukaemic lymphoblasts from both mouse and man after 24 h incubation. This unique lymphocytotoxic effect could also be demonstrated on fresh primary cultures of leukaemic lymphocytes and was highly effective on slowly growing established cell lines under crowd culture conditions. Furthermore. ultrafiltrated thymus extract did not affect the DNA synthesis rates of the viability of NC-37 lymphoblasts, which have B cell characteristic. Thymus extract was cytotoxic to Molt cells, which have T cell characteristics.


Cryoprotective agents as inducers of erythroleukemic cell differentiation in vitro. The ability of families of compounds with known and potential cryoprotective properties to induce the differentiation of Friend leukemia cells in vitro was studied. For each agent, both the proportion of differentiated cells in the culture and the total amount of heme/10(7) cells were determined. Within each family of compounds there was a direct correlation between a compound's cryoprotective ability, its ability to donate electron pairs for hydrogen bonding (basicity), and its ability to induce differentiation. While individual agents differed with respect to the proportion of cells which were induced to differentiate, the biology of the process of differentiation appeared to be similar, regardless of the agent used. A cell line which was unresponsive to DMSO was responsive to other inducers, suggesting that this DMSO-resistant cell line differed from its parent DMSO-responsive cell line either in its metabolism of the inducers or in the ability of the inducers to enter the cell. Alternatively, there may be more than one mechanism involved in the chemical induction of differentiation.


Discordant patterns of chromosome changes and myeloblast proliferation during the terminal phase of chronic myeloid leukemia. A patient with Ph1 positive chronic myeloid leukemia (CML) developed blastic transformation which by morphologic criteria appeared to be localized to the lymphatic system. Chromosome analysis at this time, however, revealed new chromosomal abnormalities in addition to the existing Ph1 in all tissues studied (lymph node, blood, and bone marrow) consisting primarily of extra chromosome numbers 19 and 9 and a second Ph1. Therapy resulted in clinical remission with significant decrease in the aneuploid cell lines. However, these reappeared with recurrence of the blast crisis. Colony formation in semisolid culture of blood and marrow cells at the time of initial blast crisis yielded growth patterns characteristic of CML. On recurrence of the blast crisis after therapy, growth patterns were characteristic of CML in blast crisis or acute myeloblastic leukemia even though blood and marrow still showed relatively low levels of myeloblasts and promyelocytes. Possible explanations are discussed for the disparity in distribution between morphologic and chromosomal abnormalities in this patient.


Characterization of two gangliosides from human leukemic polymorphonuclear leukocytes. Eight bands of gangliosides, from human polymorphonuclear leukocytes were demonstrated by thin-layer chromatography. Bands 4 and 5 were isolated and purified in sufficient amounts to allow their biochemical identification by thin-layer chromatography, gas chromatography and sequential action of glycosidases and neuraminidase. The major ganglioside was characterised as N-acetylneuraminylgalactosyl-beta-N-acetylglucosaminyl-beta-galactosyl-beta-glucosylceramide. A second ganglioside was tentatively identified as N-acetylneuraminyl-galactosyl-beta-N-acetylglucosaminyl-beta-(N-acetylneuraminyl)galactosyl-beta-glucosylceramide. Both gangliosides isolated were hydrolysed by neuraminidase. However, treatment of the intact cells with neuraminidase did not alter the ganglioside pattern.


Safety applicator for dental pins and screws.


Malignant degeneration of polyostotic fibrous dysplasia of bone.


Specific antigen stimulated lymphocyte proliferation in osteosarcoma. A lymphocyte proliferation assay (LPA) for cellular immune responses to osteosarcoma antigens is described and applied to an examination of peripheral blood lymphocytes (PBL) taken from osteosarcoma patients. The antigen preparations were derived from 3 M KC1 solubilized osteosarcoma, taken from a limited number of patients. Lymphocytes from most tumor-bearing patients were stimulated to significant proliferation when cultured in normal human serum. Such stimulation was observed whether or not the lymphoid cells were preincubated 24 hours at 37 degrees C prior to addition of antigen. Patients whose lesion had been resected and who were without evidence of disease for 5-70 months had diminished proliferative responses. Lymphocytes from normal subjects, from patients having other types of sarcoma, and patients having carcinomas rarely responded to the soluble osteosarcoma antigens. When responsive PBL taken from tumor-bearing patients were cultured in autologous serum, the proliferative responses were abrogated or blocked. Serial assays made in the course of bearing this tumor under a variety of therapeutic regimens, including an immunotherapy protocol, suggest that the LPA may be useful in monitoring clinical progress of the disease and possibly in other immunotherapy protocols for osteosarcoma.


Clinical study of rubidazone (22 050 R.P.), a new daunorubicin-derived compound, in 170 patients with acute leukemias and other malignancies. Rubidazone was used as sole chemotherapy in 170 adults and children with acute leukemia and sarcoma. When rubidazone was employed to treat the first attack, complete remission was achieved in : 1) 40 out of 70 patients (57%) with AML; 2) two out of six patients with AML where previous chemotherapy had failed; 3) four out of five patients with ALL; 4) 12 out of 14 patients with acute monoblastic leukemia. When used to treat relapse, rubidazone produced complete remission in : 1) 14 out of 31 cases of AML; 2) 18 out of 39 cases of ALL; 3) 2 out of 3 cases of non-Hodgkin lymphoma. Treatment of a case of rhabdomyosarcoma was unsuccessful. In the treatment of acute myeloblastic and monoblastic leukemias, it may be concluded that rubidazone induces a higher rate of complete remission than any other previously reported drug which was used alone. It also achieves remission rates similar to those resulting from a combination of daunorubicin and Ara-C. Furthermore, when compared with daunorubicin, rubidazone allows better control of the induction of aplasia.


Chromosomes and causation of human cancer and leukemia. XIII. An evaluation of karyotypic findings in erythroleukemia. This study was an attempt at defining the cytogenetic features of erythroleukemia (EL), particularly as related to the group of AML patients with MAKA (major karyotypic abnormalities), which generally were caused by three or more cellular events of translocation or nondisjunction. Eight of the 17 patients with MAKA had a diagnosis of EL or possible EL. In most cases, MAKA was featured by hypodiploidy, karyotypic instability, and polyploidy in the leukemic cells. The most common abnormalities were loss of B or G group chromosomes and gain of a  no. 16 or one or more marker chromosomes. Each of the markers of 2q+, Dq+, mar(A2, st), mar(C12, M), r(?F) and minute metacentric and acentric markers was observed in two or more patients. The extent of polyploidy seemed to be correlated with the proportion of erythroid precursor cells in the marrow and with the karyotypic instability. Since the patients exhibited the same chromosomal features, whether or not they had a diagnosis of EL or possible EL, and since patients without such a diagnosis also had cytologic suggestions of EL, a close relation of MAKA to EL is assumed. It is believed that patients with MAKA constitute one of the three chromosomally classifiable groups of EL.


Leukemic mitochondria. II. Acute monoblastic leukemia. Qualitative and quantitative ultrastructural studies were performed on mitochondria of leukemic monoblasts from 15 patients with acute monoblastic leukemia. Similar comparative observations were made on mitochondria of myeloblasts from 14 hematologically normal controls. No significant quantitative differences were noted between normal and leukemic mitochondria. Area measurements were approximately equal. Qualitative differences between the two groups consisted of increased numbers of irregularly shaped mitochondria, damaged mitochondrial membranes, mitochondria with damaged matrix, and small granules in mitochondria in the leukemic group. Leukemic cells exhibited nuclear-mitochondrial contact and virus-like particles within damaged mitochondria. To confirm the presence of virus-like particles and to aid in our understanding of nuclear-mitochondrial interaction, a C-type virus producer MSV-MLV infected rat embryo cell culture was used for additional analysis. Mitochondrial abnormalities and increased frequency of virus in damaged mitochondria, often attached to mitochondrial membranes, were noted. Several lysosomes exhibited accumulations of virus and budding into lysosomes from lysosomal membranes. Mitochondria are important organelles in glycolytic-oxidative phosphorylation pathways, and carry extranuclear genetic information. Further studies of morphologic and biochemical abnormalities of leukemic mitochondria and the interaction between the mitochondria and the nuclei in leukemic cells are needed to provide researchers with data on extranuclear factors operating in oncogenesis.


Chronic neurologic disturbance in childhood leukemia. Twenty-three leukemic children were studied prospectively to detect chronic effects of therapy. All patients received CNS prophylaxis, including 2400 R cranial irradiation, and intermittent maintenance therapy with intravenous methotrexate, cyclophosphamide and cytosine arabinoside. Neurologic symptoms were observed in 12 patients, all of whom had intermittent limping and mild incoordination, between the 10th and 18th month of maintenance therapy. Five of the 12 sustained seizures and four of these had subsequent abnormalities in motor, perceptual, behavioral or language development. Three school-aged children have learning disability and perceptual-motor defects. Studies of CSF folate and MTX content are presented but not helpful in delineating the etiology of these neurologic symptoms.


In vitro colony formation of transplantable rat leukemias in comparison with human acute myeloid leukemia. In vitro colony formation in two different soft agar systems was studied with bone marrow from untreated patients suffering from acute myeloid leukemia (AML) and from rats in various stages of two different transplantable myeloid leukemias. In both the thin-agar-layer system, which uses a feeder layer of fetal fibroblasts, and the Robinson culture system, human AML marrow failed to produce colonies. A similar failure was observed with the BN rat leukemia. In contrast, the Shay rat leukemic marrow produced an abnormally large number of colonies in the later stages of the disease. Evidence was obtained that the colonies produced by the Shay leukemic marrow consisted of leukemic cells, and that the disappearance of colonies from human AML and from BN rat leukemic marrow is caused by the numerical disappearance of normal pluripotent hemopoietic stem cells from the marrow and by the inability of the clonogenic leukemic cells to produce colonies in vitro. The results indicate that the BN rat leukemia is a realistic animal model for human AML.


Drug-induced stimulation of transport of hydrolyzed nitrogen mustard and choline by normal and leukemic human cells in vitro. The effect of morphine and cocaine on the transport of hydrolyzed nitrogen mustard (NH2-OH) and choline by peripheral blood cells of normal subjects and patients with chronic lymphocytic leukemia, acute lymphoblastic leukemia, and acute myeloblastic leukemia was determined. Transport of HN2-OH by lymphocytes from normal individuals and patients with chronic lymphocytic leukemia was stimulated by morphine and cocaine and, in each case, the effect was statistically significant (P less than 0.05 or greater). However, choline transport by normal lymphocytes was not altered by cocaine and was only slightly stimulated by morphine; choline transport by lymphocytes from patients with chronic lymphocytic leukemia was not stimulated by either morphine or cocaine. HN2-OH and choline transport by cells from patients with either acute lymphoblastic or myeloblastic leukemia was stimulated to a comparable degree by both drugs. Stimulation of HN2-OH transport by morphine and cocaine was greater in normal lymphocytes than in acute leukemic cells and the differences were highly significant (p less than 0.001). Conversely, stimulation of choline transport was more marked in acute leukemic cells than in normal lymphocytes, and these differences were also highly significant (p less than 0.001). It was previously shown that transport of nitrogen mustard by normal and leukemic human cells was biphasic in nature, consisting of a choline-independent component at "high" drug concentrations and a choline-dependent system at "low" substrate concentrations. The preferential stimulation of the low-dose, choline-dependent system by morphine and cocaine in acute leukemic cells relative to that observed in normal lymphocytes suggests a possible mechanism of increasing the therapeutic index of nitrogen mustard.


Acute and chronic effects of methotrexate on hepatic, pulmonary, and skeletal systems. With the progressive improvement in the survival of children with acute lymphocytic leukemia, the question of late effects of therapy on normal tissue becomes a more significant problem. In a review of a large number of children who have received long-term treatment with chemotherapy, especially methotrexate, a significant increase in the serious effects on hepatic, pulmonary, and skeletal tissue was noted. A review of the methotrexate-induced acute and chronic changes seen in these tissues is the basis for this report.


Changes in medical teaching over the past century.


Issues involved in the evaluation of velopharyngeal closure. The development and use of frontal and base-view fluorography have increased the value of cinefluorography in the evaluation of velopharyngeal closure. This paper discusses problems in the fluorographic examination of the closure mechanism, the need for other measures of velopharyngeal closure, and the validation of closure measures. Reliability data are needed for measurements made from frontal and base-view films and tapes. Measures in addition to those of a fluorographic nature are needed for the identification of persons with questionable velopharyngeal closure and for use in the evaluation of training procedures that may contribute to improved use of the velopharyngeal closure mechanism. A pattern of relationships among fluorographic and nonfluorograph measures of velopharyngeal closure can be studied in the validation of both classes of measures.


Ultrasonic measurement of lateral pharyngeal wall movement at the velopharyngeal port. Pulsed ultrasound was used to assess lateral pharyngeal wall (LPW) movement at the level of the velopharyngeal port in three adult males and two adult females. All subjects were normal talkers, and data were collected while each produced all combinations of the vowels /a/ and /i/ and consonants /p, t, k, s, m, n/ in a VCVCV context. On a qualitative basis, it appears that ultrasound technology has potential application for the measurement of LPW movement. However, a number of problems must be resolved before ultrasonic techniques surpass current methods of studying velopharyngeal function and/or incompetence.


A longitudinal study of morphological craniofacial patterns via P-A x-ray headfilms in cleft patients from birth to six years of age. 652 P-A X-ray headfilms of 51 unilateral cleft lip and palat, UCLP; 27 bilateral cleft lip and palate, BCLP; and 62 isolated cleft palate, CP were studied longitudinally at 0-3 months, 4-6 months, and annually from 1:0-6:0 years. Breadth change, height change, and growth direction of nine paired landmarks were investigated by means of the rectangular coordinate system with right to left zygomatico-frontal suture (Zf) point line as the X-axis and the perpendicular line to this X-axis at the mid-point between the right and left Zf points as the X-axis. Major findings were: (1) Study of Sphenoid body, interorbital, bizygomatico-frontal suture, and bizygomatic arch breadths showed that BCLP had a significantly broader face  than either UCLP or CP. An apparent tendency to hypertelorism still remained at 6:0 in this group while UCLP and CP groups were both close to the Bolton Standards. (2) Nasal and maxillary bredths of BCLP and UCLP were significantly wider  during the first year than in CP, but they showed only a slight growth change after the age of one year, compared to constant growth in CP. (3) All marked structural differences disappeared by 6:0 suggesting the effects of lip and/or palate surgery. (4) A slight cross-bite was found in UCLP and BCLP, but there was no such cross-bite in CP. (5) The effect of clefting was seen in mandibular dimensions where the bigonial notch was slightly broader than in non-cleft averages. (6) Upper facial height occlusal height, and posterior total facial height in each cleft group seemed to be larger than the Standard, though both maxillary height and gonial notch height approximated the Standard by 6:0 (7) From 0:3-6:0, there was no noteworthy difference among the cleft groups in either growth direction or facial symmetry of upper face and mandible. It was only in the mid-facial and dental areas that notable characteristics peculiar to the type of cleft were found. The landmarks of nasal aperture, maxilla, and dental arch showed a slight medial displacement on the affected side, although the degree and amount depended on the cleft-type.